Pet Adoption Application Form

Adoption Application, Contract and Waiver

Prospective Owner*

First NameLast Name

Birth Date

MonthDayYear

Name of Pet You Wish to Adopt*

Email Address*

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Do you own any other pets?*

Pet Name(s)

Pet Breed(s)

Pet's disposition and behavior towards other animals?

Please provide your veterinarian's name and phone number:

Do you own or rent your home?*

OwnRent

Do you have a yard?*

YesNo

If "Yes" to the above, is it fenced? please describe

What is your landlord's pet policy?*

If you rent, please provide your landlord's information here:*

Have you ever surrendered a pet you own?*

YesNo

Are there children in the home? (If yes, please list ages)*

If you answered "Yes" to the above question, please provide detail and whether they will have contact with the animal:

How many hours per day would the pet be alone (If a cat or dog)?*

Will you crate your pet? Type N/A if not an inside animal*

If you have to leave town, emergently or planned, where would your pet stay?*

How would you deal with behavioral issues such as barking, chewing, destructive behavior or unwanted behavior for any other animal?*

Please provide the names, emails, and contact numbers for 2 professional references: such as veterinarian, farrier, etc. (depending on type of animal) DO NOT just write N/A if you do not have animal related refrences, please kindly state why.*

If you answered "Yes" please provide a detailed description:

Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?*

YesNo

By clicking the submit button, I agree to Finally Home Animal Haven adoption process, will undergo a homecheck, and interview at the discretion of Finally Home Animal haven. By clicking the submit button, I understand Finally Home Animal Haven will check my references including veterinary and personal. By clicking the submit button, I understand there is an adoption donation associated with adoption of a pet from Finally Home Animal Havne and that it is tax deductible according to IRS 501(c)3 guidelines. I understand this donation will ensure the organization is equipped to rescue another homeless pet. By clicking the submit button, I understand that if I no longer want or can no longer care for my adopted pet, I agree to notify Finally Home Animal Haven by any means necessary and provide a 14 day period to allow Finally Home Animal Haven to make arrangents for my pet to be taken back into rescue. By clicking the submit button, I agree to indemnify and hold harmless Finally Home Animal Haven against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my adopted pet, once adoption has been completed. By clicking the submit button, I understand that Finally Home Animal Haven will disclose any of the pet's health or behavior issues known by the above named rescue group before adoption is completed. By clicking the submit button, I understand that if I no longer want my pet, or am no longer able to care for my adopted pet, I will be directed to surrender my pet to Finally Home Animal Haven and provide transport to where Finally Home Animal Haven if applicable. By clicking the submit button, I verify all of the above information is true and accurate.

Signature of Prospective Adopter*